Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1966-02-27
- Stop
- 1966-02-27
The parties
- Patient
- patient Lesia Catalina Ledner
- Provider
- provider In Reichert
- Payer
- payer No insurance
Record id
058279b6-7701-4823-50e2-ec2b587935af